This application seeks support for a Mentored Patient-Oriented Research Career Development Award (K23). The award would provide me the opportunity to transition to a successful independent research career focused on improving treatment adherence and outcomes for women with depression. I have had a thematic clinical and investigational interest in identifying factors that maintain depression, determining effective prevention and treatment strategies to overcome them. I have followed a career trajectory to develop a research focus in this area. The K23 mechanism will continue this trajectory, allowing me to: 1) obtain additional knowledge and skills in targeted areas pertaining to treatment adherence and transition to an independent research career in this area, 2) expand research methodology and grant-writing skills sufficiently so as to become competitive for extramural funding in this adherence/outcome arena, and 3) obtain support to pursue these academic and research goals under the mentorship of successful researcher-academicians in a multidisciplinary academic environment. Specifically, the educational and research endeavors for the proposed career development period will focus on developing incremental skills in 3 areas: I) theoretical/conceptual models (and associated methodological skills) of etiology, maintenance and treatment of depression in women, 2) exploration of how to incorporate selected psychological theoretical/conceptual models to improve treatment adherence, and 3) clinical and health services projects to objectively assess changes in treatment adherence and effectiveness of treatments for depression in women in naturalistic settings. To achieve these goals, I propose specific mentoring, coursework, didactic training, visits to national consultants, and participation in national meetings. The research plan aims to examine the underlying mechanisms and processes of psychotherapeutic approaches (Interpersonal Psychotherapy; IPT) and other psychological and interpersonal factors that might enhance treatment adherence and improve outcomes in women with depression. The first study proposed will examine the effectiveness of IPT in improving adherence and depression outcomes in pregnant women with depression. A second proposed project will examine the role of a number of factors hypothesized to affect treatment adherence in a more heterogeneous group of women (i.e. pregnant and non-pregnant) with depression in primary care. At the later stages of the proposed career development period, I will have achieved the training, mentoring and research experiences to permit independent formulation and execution of competitive ROl applications. This research has potential to meaningfully improve medication adherence, enhance outcomes and quality of life, and minimize the terrible morbidity burden experienced among women with depression.